Mrs. Christiane Lüst is the founder of the Forum for the improvement of the living conditions of old people in need of nursing care in Germany

Text of the speech which Mr. Alexander Frey, Attorney, forum member and spokesman for the Working Group Against Human Rights Violations, will deliver to the members of the Committee for Economic, Social, and Cultural Rights in Geneva on 13 August 2001

Distinguished members of the committee

Ladies and Gentlemen

I would like to thank you for giving us this opportunity to speak to you today about human rights violations in nursing homes in Germany.

Before I begin, let me briefly introduce to you my colleagues who have come here to Geneva with me today.

Mrs. Christiane Lüst is the founder of the Forum for the Improvement of the Living Conditions of old People in Need of Nursing Care in Germany

Mr. Claus Fussek, along with others, runs a service which looks after old and disabled people in need of nursing care who still live in their private homes.

Mr. Huwer has for years been engaged in solving problems existing in special homes for mentally handicapped children and adults. For a long time, he has also been a member of the Working Group Against Human Rights Violations.

In the Federal Republic of Germany there are approximately 400,000 people who live in nursing homes. The majority of these people suffer from mental illness or senile dementia (an illness of old people resulting in loss of memory and loss of control of the body’s functions).

Investigations by the medical services of health insurance companies and a number of private organizations have revealed that considerable shortcomings exist in these nursing homes:

Approximately eighty-five percent of the residents of these homes suffer from malnutrition, because care personnel frequently do not have the time to assist old people with their food intake, or their diet is not suitable for old people.

Thirty-six percent of the residents suffer from dehydration, because they simply are not given enough to drink.

Because of inadequate nutrition and also because residents often have to go for long periods without a wash or a shower, open wounds develop. Twenty-five percent of the residents suffer from decubital ulcers. Five percent suffer from a very severe type of decubital ulcer. This means that approximately 20,000 residents living in nursing homes suffer from decubital ulcers similar to the one shown in this photograph which I have brought along. This female resident was awarded DM 46,000 in damages for pain and suffering, because it could be proven that she had not been given the right nursing care.

People are provided with urinary catheters, so they need not be taken to the toilet anymore. Stomach tubes are inserted into their bodies to obviate the need to assist them during eating.

They are given very powerful psychiatric drugs to put them into a state of sedation. Nursing staff members simply do not have the time to give these old people the personal nursing care and attention they need or to be near them when they are dying.

Persons who criticize these conditions are barred from entering the nursing homes; the right to examine the records of the control authorities is denied to prevent residents from taking their case to court.

Every day, approximately 400,000 instances occur of people in nursing homes being deprived of their freedom of movement. This is accomplished, for example, with the help of restraining devices and powerful drugs. These measures frequently occur without the authorization of a court judge – in violation of German laws.

According to a study undertaken by the Social Welfare Association of Germany, the ”Sozialverband Deutschland”, which has 500,000 members, every year, approximately 10,000 people die in nursing homes throughout Germany because of the abominable conditions in these homes.

The Federal Government is utterly wrong when it refers to these cases as ”unfortunate but isolated instances,” and also when it says that on the whole, the nursing care provided is at an ”optimum” level. In Germany the nursing staff – patient ratio is usually one to two-point eight (1:2.8). This means that twenty-eight people requiring maximum nursing care have to be taken care of by ten staff members in three shifts around the clock. When you take into consideration that staff members are at various times on leave, sick leave, or attend training classes, you find that twenty-eight patients requiring maximum nursing care are looked after by no more than two or maybe three staff members and that the actual nursing care provided for each patient is less than one hour per day. Under these conditions it is impossible to give these people the humane nursing care they are entitled to!

The Federal Republic of Germany has presented draft bills for the protection of residents in special homes and to safeguard quality standards, which, however, will not bring about any improvements, because the new law does not specify how many persons are to be employed in the future for a given number of residents and how many employees must in fact be available for each resident.

The Federal Government claims that there is just not enough money available for nursing care. This is not true: Because more personnel in nursing homes would result in more money being paid into the social security pension scheme. It would also decrease the financial burden on employment offices (which have to pay unemployment money to the unemployed) and the communities (which are responsible for public assistance). Residents have to be treated in hospitals because they suffer from dehydration and decubital ulcers caused by inadequate care. These hospital costs alone run into billions of German marks. The excessive work pressure to which nursing care personnel are subjected results in more employees taking sick leave and many also become prematurely incapacitated for work due to disability. The additional costs incurred by our health insurance and social security systems due to the enormous work pressure on care personnel also run into billions of German marks every year.

The Federal Government should also take steps to prevent managers of special homes from cashing in on residents without providing adequate service in return.

Every day, thousands of offenses involving personal injury, deprivation of liberty and restriction of freedom are committed in nursing homes in the Federal Republic of Germany

It seems that Article One of the Constitution of the Federal Republic of Germany, which says that human dignity must always be respected, does not apply to old people’s nursing homes.

In old people’s nursing homes human dignity is being violated every day.

According to Article Two of the German Constitution, every human being has the right to freedom from bodily harm.

The Federal Government is an uninterested onlooker, as these fundamental rights are being violated.

Article Three of the Convention pertaining to the protection of human rights and basic freedom states that nobody may be subjected to inhumane treatment. According to Article Eleven of the international covenant on economic, social, and cultural rights of human beings, every citizen is to enjoy an adequate standard of living, including sufficient nourishment. According to Article Twelve, the contracting states recognize the right of the individual to attain the highest possible level of physical and mental wellbeing.

The Government of the Federal Republic of Germany is stepping on the basic rights of the people in nursing homes in Germany and on its international agreements as well.

The Forum for the improvement of the living conditions of old people in need of care in Germany is asking the Committee for economic, social, and cultural rights to express its concern about the situation of people living in nursing homes in Germany and to take steps to ensure that those people in nursing homes in Germany are looked after and treated humanely and with the proper medical care until they die.

Alexander Frey

Attorney and spokesman for the Working Group Against Human Rights Violations